By Jill Arnold
This week’s COTW is from (one of my favorite bloggers) Rebecca Public Health Doula, left on the post Is The Big Push for Midwives an Oppressive Campaign?.
And it got me thinking about how I see the point that opponents of licensure make. I think the lawyers in the discussion made it very clear that you’re practicing just as illegally in a state with no licensure as you are practicing without a license in a state WITH licensure. But I think people have the sense that right now those CPMs in no-licensure practice “under the radar” and can offer choices to women who otherwise would have no options at all, while once licensure comes in the vast majority will choose licensure and be restricted in their offerings; and those who don’t will be more frequently targeted and easier to prosecute. Is this based in facts and past events? I have no idea. But I almost get the sense of people in the back room whispering “Shut up you guys, you’re just attracting attention and by asking for ‘legitimacy’ you’ll ruin everything.”
I believe CPM licensure is needed and important. No, licensure does not create great midwives any more than it creates great doctors, and all consumers should do their due diligence on their health care providers (and contractors, plumbers, etc.) But it creates a system for CPMs to be recognized and integrated into the system, and it sets a basic level of competency and system of redress for professional transgressions. It enables them to practice and transport without fear and for their patients to feel comfortable hiring them. But I still think it’s a fair question of whether licensure limits the options of birthing women. Do we have any evidence that it expands it, limits it, or has no effect?